Mr. Stein's pain
 
Symptoms & History

Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

Cholelithiasis

Hereditary factors above and beyond ethnicity, so called lith genes.

  • Impaired bile salt synthesis and excretion (can't keep cholesterol in soluble form).
  • Increased serum and biliary levels of cholesterol.
Cholesterol Stone Formation
  • Bile becomes supersaturated with cholesterol.
  • Hypomotility of gallbladder promotes "nucleation."
  • Mucus hypersecretion in the gallbladder traps the cholesterol crystals, allowing aggregation into a stone.
Cholesterolosis of the gallbladder wall is another feature of high cholesterol levels and something that may play a role in stone formation. 

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